At first glance, many prescription pills look like the real thing. In reality, they're sometimes deadly fakes that are just a click away, readily available online at a cheaper price, without a prescription.

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Team 5 Investigates got a behind the scenes look into the billion-dollar business of counterfeit prescription drugs and the battle against it that has surfaced here in New England. Reporter Kathy Curran was given access by the Department of Homeland Security and Pfizer to get an inside look at the counterfeit prescription drug trade and the dangerous pills that could end up in consumer's homes.

"You don't know the pill is laced with something that can harm you; you don't know if the pills have what they say they're going to have in them. Obviously it's not regulated, not prescribed by the doctor, so the hazards can be multiple," said Bruce Foucart, head of the Homeland Security Investigations department in Boston.

Foucart told Team 5 the counterfeit pharmaceutical drug trade is a $21 billion business. Team 5 has learned federal agents are currently investigating a counterfeit prescription pill distribution ring on the Cape where the drugs are being sold on Craigslist.

Many of the pills confiscated worldwide are manufactured in Asia and sold online. "The website will indicate it's a legitimate pharmacy, but it's not. Of course they don't ask for a prescription, so alarms should go off right away," Foucart said.

"If you go on and continue to make that purchase you're sort of playing Russian roulette, you really don't know what you're going to get," said Brian Donnelly, director of Pfizer's Global Security Division.

There's not only concern about the amount of active ingredient in the drug, but about the filler. Chemists have found brick dust, boric acid and even Sheetrock in some drugs.

Handheld spectrometers revealed some Viagra pills were fake. When chemists tested the ingredients of the cancer drug Sutent, they found pills that are supposed to help save lives had no active medicine in them at all.

"Mannitol, it's a type of sugar, it's a 98 percent match to Mannitol," said one chemist working inside the lab.

"It's just as bad as putting poison in there, because they're taking away this person's chance of getting better," said Donnelly.

Some mistakes are more obvious. Expiration dates are printed wrong and the main ingredient in Viagra is misspelled on the boxes. But the real danger, investigators said, is what could be inside. "You never know what you're getting. You never know if it will hurt you, harm you or make you sick," said Foucart.

Since 2010, federal investigators have made 88 arrests related to the counterfeit prescription drug trade that has led to 63 convictions. Team 5 learned that developments in the case on Cape Cod are expected within the next month.